Provider Demographics
NPI:1639625999
Name:BROWN, SAMUEL RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:RAMON
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N. 30TH ST. CU DEPARTMENT OF SURGERY
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131
Mailing Address - Country:US
Mailing Address - Phone:402-280-4669
Mailing Address - Fax:402-280-1237
Practice Address - Street 1:601 N. 30TH ST. CU DEPARTMENT OF SURGERY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131
Practice Address - Country:US
Practice Address - Phone:402-280-4669
Practice Address - Fax:402-280-1237
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7743208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery